• (THIS AUTHORIZATION EXPIRES ONE YEAR AFTER IT IS SIGNED)
  • Please enter information of those taking Quest and Labcorp based Coronavirus Test.
    First NameLast NameDate of BirthPhone Number 
  • Sending Records From

  • NMS Management Services, Inc/Quest
    Address: 2901 S. Congress Ave
    Phone: 561-967-8884
    Fax: 561-932-1597
    City: Palm Springs
    State: Florida
    Zip: 33461
  • Sending Records To

  • Quirch Foods
    Address: 2701 Le Jeune Rd 12th Floor
    Phone: 305-691-3535
    City: Coral Gables
    State: Florida
    Zip: 33134
    Email: [email protected]
  • Authorizations

    The laboratory is required to report all testing performed to the department of health.
  • Your Information

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